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Medicare AdvantageAdministrativeMedium impact

The Consolidated Appropriations Act (CAA) Requires Accurate Provider Directory Listings

EmblemHealth·NY·Provider News
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

The Consolidated Appropriations Act (CAA) requires healthcare providers to promptly notify health plans of any changes to their provider directory information and respond to verification requests within required timeframes. Providers must also maintain accurate information in NPPES for Medicare Advantage plans and notify New York Medicaid within 15 days of any changes.

Action Required

Action needed
Immediately: Designate staff to monitor and respond to health plan verification requests through EmblemHealth/ConnectiCare provider portals. Update Provider Profile for location changes and use Message Center for corrections. For Medicare Advantage: Review and update NPI information in NPPES, removing inactive locations and adding all active practice addresses. For New York Medicaid providers: Establish process to notify Medicaid within 15 days of any address, phone, or pertinent information changes. Organizations with delegated credentialing must continue monthly data file submissions.